Sally Pezaro – Change Agent Blog

Author: Sally Pezaro @SallyPezaro
Commentator: The Edge

Posted in: Spreading Change
From: Live

Following my graduation from the School of Health and Social Care Radicals, I wanted to blog for @theedgenhs team in appreciation for how they have enabled me to reflect upon my own development as a health and social care radical.

Some time ago I wrote a different blog, reflecting on who I was and what I was doing here…. It is now time to update that story having newly reflected upon my journey.

As a midwife I was well aware of how clinical practice should be patient focused and client centered, yet I was also becoming increasingly aware that the health professionals who delivered this care were becoming burnt out through a life of service and sacrifice. I hypothesised that this situation could not be sustainable, and that the well-being of all would swiftly deteriorate unless change occurred. But how do you champion the well-being needs of staff when the patient comes first?

My challenged commenced…

I knew that I would need hard evidence to convince people of the need to change and support the well-being of staff. I started with the midwifery profession. I gathered all of the research I could find and put it together to show how and why midwives could experience psychological distress – See paper here. It is clear that midwives are in need of urgent support, and without it, patient care will deteriorate.

I quickly found evidence of staff suffering in silence because they feared a punitive response to ill health, or felt unable to disclose any impairments to those around them (Is this what happens when we make our health care workforce out to be infallible superheroes?) – So I wondered whether some form of online support may be an option for midwives to turn to when in psychological distress.

If I was going to radically approach this problem with a radical online solution, I would need to ask the midwives themselves, and other experts what I should prioritise. I designed a study to help these experts to guide the design and delivery of an online intervention to support midwives in work-related psychological distress – See study design here.

This study led to some really interesting insights into what midwives may need to effectively support them online – See results here. Overwhelmingly, midwives said that the provision of both anonymity and confidentiality online would be most beneficial to them, and would also enable them to more readily seek help and talk openly about their experiences. They also expressed a need to prioritise 24-hour mobile access, effective moderation, an online discussion forum, and additional legal, educational, and therapeutic components. It was also agreed that midwives should be offered a simple user assessment to identify those people deemed to be at risk of either causing harm to others or experiencing harm themselves, and direct them to appropriate support.

But is it ethical to allow midwives total anonymity and confidentiality online, where they could be disclosing episodes of impairment and patient safety concerns? I knew that my radical solution would not succeed unless I was able to address this ethical dilemma with the wider community. Therefore, I published my own ethical arguments online, and invited an open dialogue to involve everyone in leading this change – See ethical argument here.

As of now, I am waiting to turn my visions of radical change into practice having gathered all of the evidence I can to support this change in practice. NHS England have also been instigating some other amazing work to improve the staff experience and create compassionate health care organisations. I am excited to be involved with this work as we all now look to improve the cultures of caring for staff and one another in the workplace.

I started my journey as a radical wanting to make a radical difference to the well-being of midwives and other staff in health and social care. Throughout this journey I have found others who also want to support this change and get on board with the work I have been championing. With huge culture change, ethical challenges and the development of widespread support provisions ahead of me, I am ready to put my developing #SHCR skills to the test as I ‘rock the boat’ but also ‘try to stay in it!’

Having been a part of #SHCR, I am now undaunted by the rocky road ahead. I am ready to take my visions for change forward. Once you #FindYourFlock, you can only lift each other up and fly together. The @School4Radicals  is my flock.

I want to thank the #SHCR, NHS England, and everyone else who has become a part of my flock and supported me in turning this vision into practice. The best is yet to come!

Until next time, take care of yourselves, and each other.

Sally

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